Patient Registration

  • Registration Information

    Please fill out all information to register for your new patient appointment. We look forward to seeing you. Please contact the office with any questions or concerns. This form is encrypted & is HIPAA compliant. Thank you!
  • This is an appointment to evaluate treatment options for mental health conditions. Which of the following treatment options are you seeking?*
  • How did you hear about us?*

  • Thank you for reaching out to us.  At this time, Novus Behavioral Health specializes in Psychiatry  only.  We do not have therapists on staff at this time.  The focus of psychiatry is primarily on optimizing medications.  Visits take place approximately once per month during medication optimizing phase of treatment.  Once medications have been optimized visits take place approximately once every 3 months. Brief supportive psychotherapy is provided during visits.

    Psychotherapy, on the other hand, provides counseling only.  Visits occur more frequently - usually one hour weekly or biweekly & are longer in duration, usually 50-60 minutes.  

    In the future, we will offer counseling in addition to medication management. 

    In the meantime please provide your name & mobile phone number so that we may text you the information of therapists in the area.   

    Thank you! 

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  • Preferred communication method*
  • Do you agree to receive text communication?*
  • Birth sex*

  • Identified gender

  • Date of Birth*
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  • Preferred Appt Type*
  • Reason for your visit:*

  • Emergency Contact Information

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  • Payment Information

  • Preferred Payment Method*
  • Primary Insurance Subscriber’s Sex
  • Primary Insurance Effective Date
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  • Primary Insurance Subscriber’s Date of Birth
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  • Patient’s relationship to subscriber of Primary Insurance

  • Secondary Insurance Information

  • Secondary Insurance Subscriber’s Date of Birth
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  • Secondary Insurance Subscriber’s Sex
  • Patient’s relationship to subscriber of Secondary Insurance

  • Insurance Card & Identification

  • Should be Empty: